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[MoveCAtoBetterHealth] Common Misconceptions
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Common Misconceptions About

Direct Access


  • Direct access will result in more physical therapy visits.
  • Physical therapists aren't trained to recognize conditions that are outside the physical therapy scope of practice.
  • Physical therapists will hurt patients.
  • Physical therapists do not want to collaborate with physicians.

True: Direct access results in fewer physical therapy visits, not more.

  • The role of the physician gatekeeper relative to physical therapy may be unnesessary in many cases.

- Source: The University of Iowa study (2011)

  •  A recent collaboration among Intel Corporation, two health care systems and an insurer showed that patients with direct access to physical therapist treatment completed their physical therapy within 21 days, compared to 52 days without direct access.

True: Physical therapists are fully trained to recognize conditions outside their scope of practice.

  • It is assumed that direct access would tempt a physical therapist to perform treatment that is best provided by a physician. However, physical therapists are educated and trained to refer pateints to a physician when they observe signs and symptoms inconsistent with a patient's known diagnosis or that could represent undiagnosed medical conditions. Also, data on physical therapy liability and malpractice claims indicate that there is no difference in patient safety between physical therapists practicing in states with and without direct access Physical therapists are responsible for meeting standards of practice regardless of whether there is a diagnosis or not. Direct access does not change this.

True: California physical therapists set the highest standards for patient safety, and numerous studies demonstrate that licensed physical therapists provide safe, high-quality care.

  • Liability insurers and the Federation of State Boards of Physical Therapy affirm that direct access does not jeopardize the health, safety or welfare of individuals seeking physical therapist services without referral. There has been no increase in malpractice rates or disciplinary actions against physical therapists in jurisdictions with direct access.

True: Physical therapists value collaboration with physicians in meeting patient needs.

  • Physicians will continue to play an important role in treating patients. And there is likely to be greater collaboration between physical therapists and physicians with direct access, not less. Physical therapists will continue to refer to physicians as needed, as well as receive referrals from them. In addition, individuals who seek physical therapy services through direct access will be more likely to be referred to a physician for needed medical care than if they obtained services from unlicensed health care practitioners.


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